Transition of Vivax Malaria from Benign to Malignant Clinical Profile: A Cause of Concern

This present research aimed to study hepatic dysfunction, renal dysfunction and prevalance of thrombocytopenia in 
children with malaria in tertiary care centre of   Bundelkhand region. Children in the age groups of 1 to 15 yrs, whose 
peripheral smear were positive for malarial parasite   were included in the study group from amongst those admitted in 
pediatric  ward  of  tertiary  care  hospital  in  Jhansi. A  detailed  history  and  clinical  examination  was  done,  followed  by 
investigations like hemogram, platelet   count general blood picture, reticulocyte count, serum bilirubin, SGOT, SGPT, 
serum alkaline phosphatase, blood urea and serum creatinine. Raised level  of SGPT, SGOT and total serum bilirubin  were 
seen in 31%, 30% 53% respectively. In our study 11% of cases had raised level of blood urea or serum creatinine or both. 
Greatest affected group was 10-15 yrs in which 6 cases had increased urea and creatnine level. There were 88 cases (88%) in 
which platelet count was < 1.5 lac/Cu mm, among them P.falciparum cases were 47(47%) and P.vivax cases were 41(41%). 
Liver functions are  commonly affected in malaria and liver dysfunction  ranges from mild elevation of liver enzymes to the 
range  of  acute  hepatitis  .  There  was  no  significant  difference  in  incidence  of  thrombocytopenia  between  vivax  and 
falciparum cases. Mild renal impairement was present in a number of cases and it was noted that dehydration also plays role 
in the genesis of renal impairement in children with malaria.